AB1376 CENTRAL SENSITIZATION IN AUTOIMMUNE CONNECTIVE TISSUE DISEASES: IS IT RELATED TO DISEASE ACTIVITY, COEXISTING FIBROMYALGIA, AND LABORATORY FINDINGS?
Authors: Z. Bazancİr Apaydİn, H. Apaydin, B. Armagan, K. Gok, S. Erten
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Central sensitization (CS) is a phenomenon associated with chronic pain disorders and may be seen in several rheumatic diseases with chronic musculoskeletal pain such as osteoarthritis, spondyloarthropathy, and fibromyalgia, but little is known about CS in patients with autoimmune connective tissue diseases (ACTDs). <h3>Objectives</h3> The purpose of the study was to investigate the role of CS in patients with ACTDs and how it relates to disease activity, coexisting fibromyalgia, and laboratory findings. <h3>Methods</h3> A total of 82 patients (mean age 49.2±13.1 years) with ACTDs were included and were divided into three groups in terms of their diseases: Sjögren's syndrome (SS), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE). The CS was assessed using the central sensitization inventory (CSI-A and CSI-B scores). The disease activity (using Sjögren's syndrome disease activity index, ESSDAI, for SS; Disease Activity Score-28 C-reactive protein, DAS28-CRP, for RA; and Systemic Lupus Erythematosus Disease Activity Index, SLEDAI, for SLE), pain intensity (using visual analog scale), coexisting fibromyalgia, and laboratory findings (erythrocyte sedimentation rate-ESR and C-reactive protein-CRP) of all patients were evaluated. <h3>Results</h3> CS were present in 39% of all ACTDs patients (57.1% in SS, 36.8% in RA, and 26.1% in SLE). No significant differences were found in the CSI-A score (p = 0.161) and CSI-B score (p = 0.809) among the groups. There was a significant correlation between disease activity and the CSI-A scores in patients with RA (p = 0.027, r = 0.360), but no significant relationship between disease activity and the CSI-A scores in SS (p = 0.390) or SLE patients (p = 0.179). CSI-A and CSI-B scores were higher in the coexisting fibromyalgia in patients with ACTDs (p = 0.002, p &lt; 0.001, respectively). There is no significant relationship between CSI-A scores and laboratory findings (ESR, CRP) in patients with ACTDs (p &gt; 0.05). <h3>Conclusion</h3> CS is seen as a common condition in patients with ACTDs who also have fibromyalgia and is related to the disease activity in patients with RA. In addition to specific pharmacological treatments, pain-coping strategies may reduce pain and increase the quality of life of patients with these conditions. It is essential to increase awareness about the important role played by CS pain in patients with ACTDs. <h3>References</h3> [1]Guler MA, Celik OF, Ayhan FF. The important role of central sensitization in chronic musculoskeletal pain seen in different rheumatic diseases. Clin Rheumatol. 2020 Jan;39(1):269-274. doi: 10.1007/s10067-019-04749-1. [2]Trouvin AP, Attal N, Perrot S. Assessing central sensitization with quantitative sensory testing in inflammatory rheumatic diseases: A systematic review. Joint Bone Spine. 2022 Oct;89(5):105399. doi: 10.1016/j.jbspin.2022.105399. [3]Neblett R, Cohen H, Choi Y, Hartzell MM, Williams M, Mayer TG, Gatchel RJ. The Central Sensitization Inventory (CSI): establishing clinically significant values for identifying central sensitivity syndromes in an outpatient chronic pain sample. J Pain. 2013 May;14(5):438-45. doi: 10.1016/j.jpain.2012.11.012. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.